Communication Disability Centre, University of Queensland, Brisbane, Australia.
J Adv Nurs. 2012 Jan;68(1):116-26. doi: 10.1111/j.1365-2648.2011.05722.x. Epub 2011 Aug 10.
Effective nurse-patient communication is an essential aspect of health care. Time to communicate, however, is limited and subject to workload demands. Little is known about how nurses manage this 'lack of time' when caring for patients with developmental disability and complex communication needs, who typically communicate at a slow rate.
The aim of this study was to investigate nurses' expressed concepts of 'time' in stories about communicating with patients with developmental disability and complex communication needs in hospital.
In 2009, 15 hospital nurses from a range of wards in two metropolitan hospitals participated in interviews about barriers to and strategies for successful communication with patients with developmental disability and complex communication needs in hospital. The data were analysed using narrative inquiry methodology and the stories verified with the participants.
Nurses identified 'time' as a barrier and a facilitator to successful communication. Time as a barrier was related thematically to avoiding direct communication and preferring that family or paid carers communicated on behalf of the patient. Time as a facilitator was related to valuing communication, investing extra time, and to applying a range of adaptive communication strategies to establish successful communication.
Time is perceived by nurses as both an enemy and friend for improving communication. Nurses who perceive that communication takes too long may avoid communication and miss opportunities to improve communication through increased familiarity with the person's communication methods. Those who take time to communicate narrate applying a range of strategies to achieve success in basic needs communication.
有效的护患沟通是医疗保健的一个重要方面。然而，沟通的时间是有限的，并受到工作量的需求的限制。对于护士在照顾有发育障碍和复杂沟通需求的患者时如何管理这种“缺乏时间”的情况，了解甚少，这些患者的沟通通常比较缓慢。
本研究旨在探讨护士在讲述与在医院中具有发育障碍和复杂沟通需求的患者进行沟通时，对“时间”的表达概念。
在 2009 年，来自两个大都市医院的多个病房的 15 名医院护士参与了关于在医院中与发育障碍和复杂沟通需求患者进行成功沟通的障碍和策略的访谈。使用叙事探究方法对数据进行分析，并与参与者一起验证这些故事。
护士将“时间”确定为成功沟通的障碍和促进因素。时间作为障碍的主题与避免直接沟通和倾向于让家庭或付费护理人员代表患者进行沟通有关。时间作为促进因素与重视沟通、投入额外的时间以及应用一系列适应性沟通策略来建立成功的沟通有关。
护士认为时间既是改善沟通的敌人也是朋友。那些认为沟通时间过长的护士可能会避免沟通，并错过通过增加对患者沟通方式的熟悉度来改善沟通的机会。那些花时间进行沟通的护士会讲述应用一系列策略来实现基本需求沟通的成功。
